Arterial Blood Gases (ABG)

Question 1

What is the main goal of an ABG?

Answer 1

To identify if it’s an acidosis or alkalosis

Question 2

Rules of the B’s

Answer 2

If pH and BICARB are BOTH in the same direction then it is METABOLIC

Question 3

Normal pH

Answer 3

7.35-7.45

Question 4

Normal BICARB

Answer 4

22-26

Question 5

Normal CO2

Answer 5

35-45

Question 6

If pH and BICARB are in different direction

Answer 6

RESPIRATORY

Question 7

Example: low ph, low bicarb

Answer 7

Metabolic acidosis

Question 8

Ex : high ph, high bicarb

Answer 8

Metabolic Alkalosis

Question 9

Ex: low ph, high bicarb

Answer 9

Respiratory acidosis

Question 10

Ex: pH= 7.50, bicarb= 25

Answer 10

Respiratory alkalosis

Question 11

Basic principle of knowing the signs and symptoms for acidosis and alkalosis

Answer 11

As the pH goes, so goes my patient ( meaning, when pH is high, the s/s of patient is on hyper. When pH is low, the s/s of patient slowly shuts down)

Question 12

Example of low signs and symptoms during acidosis

Answer 12

Hyporeflexia
Bradycardia 
Bradypnea
Lethargy 
Obtunded (1 step lower than lethargic) 
Coma
Paralytic ileus

Question 13

Examples of high signs and symptoms during alkalosis

Answer 13

Irritability 
Hyperreflexia
Tachypnea
Tachycardia
Borborygmi (increased bowel sounds)
Seizure
Spasm

Question 14

Medical term for increased bowel sounds

Answer 14

Borborygmi

Question 15

Acidosis leads to?

Answer 15

Respiratory arrest

Question 16

When in respiratory arrest, what needs to be at the bedside?

Answer 16

Ambu bag

Question 17

Alkalosis leads to

Answer 17

Seizure

Question 18

When in risk of seizure during the phase of alkalosis, what needs to be at the beside?

Answer 18

Suction machine

Question 19

ABG analysis for Kussmaul Breathing

Answer 19

Metabolic acidosis ( remember: MacKussmaul)

Question 20

ABG reading: Client over ventilating

Answer 20

Respiratory alkalosis

Question 21

ABG reading: Client under ventilating

Answer 21

Respiratory acidosis

Question 22

What is most concerning when identifying respiratory acidosis or alkalosis( under or over ventilating) , is it the Respiratory rate? Or O2 saturation (SaO2)?

Answer 22

SaO2

Question 23

Ex: patient is overusing breathing techniques during labor

Answer 23

Respiratory alkalosis (over ventilating )

Question 24

Ex: near drowning

Answer 24

Respiratory acacidosis ( under ventilating)

Question 25

Ex: emphysema, air trapping

Answer 25

Respiratory acidosis ( under ventilating)

Question 26

Ex: PCA pump

Answer 26

Respiratory acidosis (under ventilating, respiaratory depression )

Question 27

ABG reading: Patient who has prolonged gastric vomiting and suctioning

Answer 27

Metabolic alkalosis

Question 28

ABG Reading: hyperemesis gravidarum

Answer 28

Metabolic alkalosis

Question 29

ABG Reading: dehydration

Answer 29

Metabolic acidosis

Question 30

ABG Reading: acute renal failure

Answer 30

Metabolic acidosis (why? Because it’s not long, not vomiting, not suctioning )

Question 31

ABG Reading: 3rd degree burn, 60% body, 1st phase

Answer 31

Metabolic acidosis

Question 32

Compensation: all levels or values are out of range

Answer 32

Partially Compensated

Question 33

Compensation: if the pH is out of range and only one of the other values is out of range

Answer 33

Uncompensated

Question 34

Remember:

For the rest, if you dont know what if is

Answer 34

Metabolic acidosis

Question 35

Hyporeflexia Finding

Answer 35

0, +1

Question 36

Normoreflexia finding

Answer 36

+2

Question 37

Hyperreflexia Finding

Answer 37

+3, +4